https://www.ncbi.nlm.nih.gov/pubmed/31124886 NAFLD
J Pediatr Gastroenterol Nutr. 2019 May 18. doi: 10.1097/MPG.0000000000002401. [Epub ahead of print]

Psychotropic Medications are Associated with Increased Liver Disease Severity in Pediatric NAFLD.

Mouzaki M1, Yodoshi T1, Arce-Clachar AC1, Bramlage K1, Fei L2, Hunsaker SL3, Xanthakos SA1.

Abstract

OBJECTIVES:
To determine whether pediatric patients with non-alcoholic fatty liver disease (NAFLD) exposed to psychotropic medications have more severe liver disease compared to their counterparts who are not on these medications. We hypothesize that use of psychotropic agents is associated with liver disease severity.

METHODS:
Children and adolescents with biopsy confirmed NAFLD were included in this study. Histology data, detailed clinical information and results of serum biochemistries performed within three months of the liver biopsy were collected retrospectively. Univariate and multivariate modeling was used to determine differences between the groups and to control for confounders.

RESULTS:
228 patients were included, 17 (8%) of whom where on psychotropic medications at the time of the liver biopsy. Patients on psychotropic medications were more likely to also be on metformin (53% vs. 18%, p < 0.01) and anti-hypertensive medications (29% vs. 8%, p < 0.01) compared to children with NAFLD who were not on psychotropic agents. There were no differences in regards to biochemical evidence of liver injury, insulin resistance and dyslipidemia between the groups. On histology however, the use of psychotropic medications was associated with increased steatosis severity (score 2.4 vs. 1.9, p = 0.04) and increased likelihood of having a NAFLD Activity Score ≥5 (seen in 59% vs. 35% or patients; p = 0.05, respectively).

CONCLUSIONS:
In this large cohort of children with biopsy confirmed NAFLD, the use of psychotropic medications was associated with increased liver disease severity. Exposure to psychotropic agents should be considered when risk stratifying children with NAFLD.